Caecocystoplasty for intractable interstitial cystitis: long-term results

OBJECTIVE: To evaluate the role of orthotopic substitution caecocystoplasty in intractable interstitial cystitis refractory to conservative measures by looking at long-term follow-up results. PATIENTS AND METHODS: We present a retrospective review of eleven patients who underwent a trigone-preserving orthotopic substitution caecocystoplasty for intractable classical interstitial cystitis. All patients received conservative treatment for a mean period of three years. They were followed up for a mean period of nine years (range 4-14 years) with evaluation of symptoms, biochemistry, ultrasound scan and flexible cystoscopy. RESULTS: Symptomatic relief was universal with an increase of bladder capacity to normal. There was no mortality and the postoperative morbidity was minimal. Intermittent self-catheterisation due to high residual volumes was necessary in two patients. There was no significant urinary reflux or metabolic complications noted. Two patients required a cystectomy after four and six years respectively due to recurrent trigonal disease in one and urethro-trigonal hypersensitivity following intermittent self-catheterisation in the other patient. One patient developed an advanced adenocarcinoma in the caecal segment seven years following the primary operation. CONCLUSION: A sustained relief of symptoms is noted after trigone-preserving orthotopic substitution caecocystoplasty in intractable classical interstitial cystitis. It may not be appropriate in patients with urethro-trigonal disease or hypersensitivity. There is low long-term morbidity due to the operation but is associated with malignancy in the augmentate. Long-term follow-up is necessary to identify malignant change in the bladder.     

Minimally Invasive Surgery in Pediatric Cancer Patients

Background: The specific use of minimally invasive surgery (MIS) in pediatric cancer patients is limited. We evaluated the 5-year experience at a single institution with MIS in children with malignancies.Methods: A retrospective review was undertaken of all MIS performed between November 1995 and October 2010434_2004_Article_340.Results: A total of 101 pediatric oncology patients underwent 113 MIS procedures—64 laparoscopic (57%) and 49 thoracoscopic (43%)—during this period. Laparoscopy was performed for diagnostic purposes in 27 cases (42%) and was successful in 25 (93%) cases. Laparoscopic tumor resection was performed in seven cases (11%). Thirty additional laparoscopic procedures (47%) were attempted for complications of the malignancy or its treatment. Four of these cases were converted to open laparotomies. Indications for thoracoscopy included the evaluation of a mediastinal mass (n = 7) or biopsy or resection of pulmonary lesions (metastatic, n = 31; infectious, n = 9). Fourteen cases (29%) had to be converted to open thoracotomy procedures, generally because of the inability to localize a lesion. The other 35 procedures were successful. The overall complication rate was 5%. No trocar site recurrences or infections were observed.Conclusions: We conclude that MIS in pediatric cancer patients is a safe and effective diagnostic modality. The role of MIS for primary tumor resection remains to be defined.     

Dental caries and oral hygiene status of 13-14 year old school children of Davangere

2,007 children from 11 schools, selected through stratified random sampling were examined for dental caries and oral hygiene status. The Mean DMFT was found to be 2.85 and 3.40, mean DMFS 3.76 and 4.56 in 13 and 14 year olds, respectively. Females recorded higher mean values of DMFT (3.37) than males (2.94). There was no significant difference in the mean values of OHI (S). The overall prevalence of dental caries was found to be higher among 14-year-old children compared to 13 year children.